p53、O^(6)-甲基鸟嘌呤-DNA甲基转移酶在老年脑胶质瘤患者中的表达及其与预后的相关性分析

Expression of p53 and O^(6)-methylguanine-DNA methyltransferase in elderly patients with glioma and their correlation with prognosis

目的探究p53、O^(6)-甲基鸟嘌呤-DNA甲基转移酶(O6-methylguanine-DNA methyltransferase,MGMT)在老年脑胶质瘤患者中的表达及其与预后的相关性。方法选取2019年8月至2022年6月新疆喀什地区第二人民医院收治的49例老年脑胶质瘤患者的组织标本为试验组,另选取新疆喀什地区第二人民医院同期收治的35例高血压性脑出血患者的正常脑组织标本为对照组。根据WHO分级将老年脑胶质瘤患者分为Ⅰ/Ⅱ级老年脑胶质瘤组(21例)和Ⅲ/Ⅳ级老年脑胶质瘤组(28例)。根据预后不同将老年脑胶质瘤患者分为预后不良组(27例)和预后良好组(22例)。比较分析对照组与试验组患者的p53、MGMT阳性表达率,不同级别老年脑胶质瘤患者的p53、MGMT阳性表达率,不同预后老年脑胶质瘤患者的p53、MGMT阳性表达率。分析p53、MGMT阳性表达率与老年脑胶质瘤患者临床病理特征的关系以及p53、MGMT阳性表达率与老年脑胶质瘤患者预后的相关性。采用受试者工作特征曲线分析p53、MGMT阳性表达率对老年脑胶质瘤患者预后不良的预测价值。结果试验组患者的p53、MGMT阳性表达率均显著高于对照组(P<0.05)。Ⅲ/Ⅳ级老年脑胶质瘤组患者的p53、MGMT阳性表达率均显著高于Ⅰ/Ⅱ级老年脑胶质瘤组(P<0.05)。预后不良组患者的p53、MGMT阳性表达率均显著高于预后良好组(P<0.05)。p53、MGMT阳性表达率与老年脑胶质瘤患者的性别、年龄、肿瘤大小、肿瘤位置等临床病理特征无关(P>0.05)。Pearson相关性分析结果显示,p53、MGMT阳性表达率均与老年脑胶质瘤患者的预后呈显著负相关(r=-0.575,P=0.001;r=-0.528,P=0.001)。受试者工作特征曲线分析结果显示,血清p53、MGMT阳性表达率联合指标预测老年脑胶质瘤患者预后不良的曲线下面积为0.912,显著高于p53阳性表达率(曲线下面积为0.734)和MGMT阳性表达率(曲线下面积为0.788)单一指标(P<0.05)。结论脑胶质瘤组织中的p53、MGMT阳性表达率明显升高,与肿瘤分级、预后显著相关,且对老年脑胶质瘤患者的预后不良具有一定预测价值。

Objective To explore the expression of p53,O^(6)-methylguanine-DNA methyltransferase(MGMT)in elderly patients with glioma and their correlation with prognosis.Method Tissue samples of 49 elderly patients with glioma treated in the Second People’s Hospital of Kashgar from August 2019 to June 2022 were selected as the experimental group,and normal brain tissue samples of 35 patients with hypertensive cerebral hemorrhage treated in the Second People’s Hospital of Kashgar during the same period were selected as the control group.According to WHO classification,the elderly glioma patients were divided into gradeⅠ/Ⅱglioma group(21 cases)and gradeⅢ/Ⅳglioma group(28 cases).According to the different prognosis,the elderly glioma patients were divided into poor prognosis group(27 cases)and good prognosis group(22 cases).The positive expression rates of p53,MGMT in control group and experimental group,in gradeⅠ/Ⅱglioma group and gradeⅢ/Ⅳglioma group,poor prognosis group and good prognosis group were compared and analyzed.To analyze the relationship between positive expression rates of p53,MGMT and clinicopathological features of elderly patients with glioma,the correlation between positive expression rates of p53,MGMT and prognosis of elderly patients with glioma.The predictive value of positive expression rates of p53,MGMT for poor prognosis in elderly patients with glioma was analyzed by ROC curve.Result The positive expression rates of p53,MGMT in experimental group were significantly higher than those in control group(P<0.05).The positive expression rates of p53,MGMT in gradeⅢ/Ⅳglioma group were significantly higher than those in gradeⅠ/Ⅱglioma group(P<0.05).The positive expression rates of p53,MGMT in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).The positive expression rates of p53,MGMT were not correlated with gender,age,tumor size or tumor location in elderly glioma patients(P>0.05).Pearson correlation analysis showed that the positive expression rates of p53,MGMT were significantly negatively correlated with the prognosis of elderly glioma patients(r=-0.575,P=0.001;r=-0.528,P=0.001).The ROC curves showed that the area under the curve of the combined index of positive expression rate of p53,MGMT predicted poor prognosis of elderly glioma patients was 0.912,which was higher than the positive expression rate of p53 with the area under the curve of 0.734 and the positive expression rate of MGMT with the area under the curve of 0.788(P<0.05).Conclusion The positive expression rates of p53,MGMT in glioma tissue were significantly increased,which was significantly correlated with tumor grade and prognosis,and had certain predictive value for poor prognosis in elderly glioma patients.